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NPI Code Detail

MEDICARE: KAYLA VAN WYK

MEDICARE: KAYLA VAN WYK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902667868
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA VAN WYK
Provider Business Mailing Address
First Line : 929 BROADWAY ST
Second Line :
City : PELLA
State : IA
Zip : 50219-1436
Country : US
Telephone Number : 641-780-0528
Fax Number :
Provider Business Practice Location Address
First Line : 315 MAIN ST
Second Line :
City : PELLA
State : IA
Zip : 50219-1918
Country : US
Telephone Number : 641-628-1723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2024
Last Update Date : 01/18/2024

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Directions to “ KAYLA VAN WYK ” Practice Location

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